• Title/Summary/Keyword: hospital pharmacy

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Risk Factors of Postoperative Nosocomial Pneumonia in Stage I-IIIa Lung Cancer Patients

  • Wang, Zeng;Cai, Xin-Jun;Shi, Liang;Li, Fei-Yan;Lin, Neng-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3071-3074
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    • 2014
  • Background: To investigate the related risk factors of postoperative nosocomial pneumonia (POP) in patients withI-IIIa lung cancer. Methods: Medical records of 511 patients who underwent resection for lung cancer between January 2012 to December 2012 were retrospectively reviewed. Risk factors of postoperative pneumonia were identified and evaluated by univariate and multivariate analyses. Results: The incidence of postoperative pneumonia in these lung cancer patients was 2.9% (15 cases). Compared with 496 patients who had no pneumonia infection after operation, older age (>60), histopathological type of squamous cell carcinoma and longer surgery time (>3h) were significant risk factors by univariate analysis. Other potential risk factors such as alcohol consumption, history of smoking, hypersensitivity, hypertension, diabetes mellitus and so on were not showed such significance in this study. Further, the multivariate analysis revealed that old age (>60 years) (OR 5.813, p=0.018) and histopathological type of squamous cell carcinoma (OR 5.831, p<0.001) were also statistically significant independent risk factors for postoperative pneumonia. Conclusions: This study demonstrated that being old aged (>60 years) and having squamous cell carcinoma histopathological type might be important factors in determining the risk of postoperative pneumonia in lung cancer patients after surgery.

Molecular Cloning and Characterization of a Novel Calcium-dependent Protein Kinase Gene IiCPK2 Responsive to Polyploidy from Tetraploid Isatis indigotica

  • Lu, Beibei;Ding, Ruxian;Zhang, Lei;Yu, Xiaojing;Huang, Beibei;Chen, Wansheng
    • BMB Reports
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    • v.39 no.5
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    • pp.607-617
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    • 2006
  • A novel calcium-dependent protein kinase gene (designated as IiCPK2) was cloned from tetraploid Isatis indigotica. The full-length cDNA of IiCPK2 was 2585 bp long with an open reading frame (ORF) of 1878 bp encoding a polypeptide of 625 amino acid residues. The predicted IiCPK2 polypeptide included three domains: a kinase domain, a junction domain (or autoinhibitory region), and a C-terminal calmodulin-like domain (or calcium-binding domain), which presented a typical structure of plant CDPKs. Further analysis of IiCPK2 genomic DNA revealed that it contained 7 exons, 6 introns and the length of most exons was highly conserved. Semi-quantitative RT-PCR revealed that the expression of IiCPK2 in root, stem and leaf were much higher in tetraploid sample than that in diploid progenitor. Further expression analysis revealed that gibberellin ($GA_3$), NaCl and cold treatments could up-regulate the IiCPK2 transcription. All our findings suggest that IiCPK2 might participate in the cold, high salinity and GA3 responsive pathways.

Evaluation of Pharmacists Medication Teaching Service for Hospitalized Cancer Patients (입원한 환자에 대한 약사의 복약지도 서비스 평가)

  • Shin, Moon Hee;Oh, Jung Mi;Jeong, Kyung Ju;Choi, Seung Ki;Shin, Hyun Taek
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.2
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    • pp.76-84
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    • 2002
  • The purpose of this study was to evaluate the patient education provided by the pharmacist for cancer patients receiving chemotherapy in the hospital. One time patient medication teaching including verbal instruction and written materials were provided by a pharmacist for cancer patients receiving chemotherapy on the first or second day of hospitalization. After providing medication teaching by a pharmacist a written survey was performed in order to measure the patient's satisfaction with the medication teaching and to evaluate the effectiveness of the patient medication teaching. This one-time patient medication teaching by a pharmacist was provided for 44 solid and hematological cancer patients (23 male, 21 female). The results of 27 written surveys completed by the cancer patients revealed that almost all cancer patients $(96.3\%)$ felt that medication teaching is a must in order to understand and accept the chemotherapy by cancer patients. In addition, almost all patients $(92.6\%)$ stated that they were extremely satisfied with the medication teaching provided by the pharmacist. The levels of understandings on the chemotherapy.

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Development of National Liscensing Examinaion for Improvement of Pharmacist (약사직능수행 향상을 위한 약사국사시험 개선에 관한 연구)

  • Moon Sang Whang;Chang Jong Kim
    • Proceedings of the PSK Conference
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    • 1999.06a
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    • pp.2-22
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    • 1999
  • To maximize the services of phatmacists, we studied the best national liscensing examination for improvement of pharmacist. Among 650 Pharmacist who are posed the questions, 282 pharmacist such as professor in college of pharmacy(46), pharmacists in drug store and hospital (136), administrators in The Ministry of The Health and Welfare(48) and researchers and phamacists in pharmaceutical company (52) replied it. By analyzing these questionares, the results were as follows: In the Korean national liscensing examination for medial care team, pharmacist has been examed over two times the subjects as compared with another national examinations for medical and public health liseneses and 6-year curriculum of medical school. Now, the national examination for pharmacy liscence have been tested the basic subjects such as pharmaceutical analytical chem-istry, medicinal chemistry, biochemistry, etc., but almost demander, pharmacist who has been engaged about over 80% in the drug stores and hospital pharmacy, want to have exam pharmacy practics which are clinical pharmacy, pathohysiology and pharma-cotherapy of diseases like The United State of America, but not basic chemisty and biology. If the Korean liscensing examination for pharmacy will be changed like America, pharmacy education in the college of phar-macy will be progressed in detail. There are no clerkships and internships in the pharmaceutical education program in Korea, and so most of pharmacist want to have 6-year curriculum for pharmacy education and to test the pharmacy practice for Doctor of Pharmacy(Pharm. D.) but not basic science.

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Evaluation of the Appropriateness of Empirical Antibiotic Prescription after Implementation of Antibiotic Treatment Guidelines for Pneumonia in a Hospital (원내 폐렴 진료 지침 수립 후 경험 항생제 선택의 적절성 평가)

  • Kang, Jiyoung;Kim, Hyungsook;Jeong, Youngmi;Namgung, Hyungwook;Lee, Eunsook;Lee, Euni;Hwang, Joohee;Song, Kyoungho;Kim, Eusuk;Kim, Hongbin
    • Journal of Korean Society of Health-System Pharmacists
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    • v.35 no.4
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    • pp.391-399
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    • 2018
  • Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

Comparison of Antibiotic Regimens for the Treatment of Community Acquired Pneumonia (원외획득 폐렴 환자치료에서 항생제 regimen 별 효능비교)

  • Moon, Hong-Seop;Choe, In;Lee, Seung-Il
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.81-85
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    • 2006
  • Community acquired pneumonia(CAP) is the most prevalent disease among pneumonia patients and progressed to severe pneumonia. A retrospective study was performed to evaluate antibiotic regimens according to guidelines of Infectious Disease Society of America. From January to October 2005, chart review of 50 patients with CAP was peformed in terms of microbiology and laboratory data of each regimen. Temperature, WBC count, ALT, AST and alkaline phosphatase of each patient were examined for liver toxicity. In three patients received levofloxacin appeared to have normalized temperature and improved cough. The patients who received cefmetazole -aminoglycoside appeared to have worsen LFT(Liver function test). Many patients in flomoxef-aminoglycoside group received mechanical ventilation because of the basis diseases like tuberculosis, diabetes mellitus and hypertension. In conclusion, antibiotic therapy for the treatment of CAP should be selected according to tolerance, bacteria and severity of disease.

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Unusual Symptom of Hypertension associated with Amoxicillin (Amoxicillin에 의한 비정상적 증상인 고혈압)

  • Cho, Young Ah;Choi, Eun Joo;Yoon, Hyonok
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.206-208
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    • 2020
  • An 80-year-old Korean woman who previously experienced penicillin allergy presented to a dental hospital for treatment of a fractured tooth. A dentist extracted the tooth and prescribed her A-cillin (amoxicillin hydrate) 250 mg orally 3 times a day for 3 days and Carol-F® (ibuprofen arginine) orally 3 times a day for 3 days. She received the prescriptions, returned home, and took one dose of each drug. One hour later, she experienced hypertension, itching, shortness of breath, and was unable to move her tongue to pronounce words. Approximately 6 hours after drug administration, the symptoms persisted, and the patient was admitted to an emergency medical center (EMC). The patient was discharged from the EMC after a one-night stay in the hospital for symptomatic treatment.

Real-world Treatment Pattern and Outcomes of Hypercalcemia among Solid Tumor Patients (성인 고형암 환자의 고칼슘혈증 치료현황과 치료효과 분석)

  • Shin, Da Eun;Park, Seol Hee;Kim, Sung Hwan;Suh, Sung Yun;Jo, Yun Hee;Cho, Yoon Sook;Im, Seock-Ah;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.166-172
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    • 2019
  • Background: Hypercalcemia is an important metabolic emergency condition in cancer patients. Bisphosphonate is the treatment of choice for hypercalcemia, whereas calcitonin and hydration with furosemide are recommended for acute supportive therapy. However, data regarding real-world treatment patterns and outcomes of pharmacological treatments are limited. Therefore, we aimed to investigate the treatment patterns and clinical outcomes of hypercalcemia treatment in solid tumor patients. Methods: Electronic medical records of 123 adults with solid cancers and albumin-corrected calcium levels >10.5 mg/dL or ionized calcium levels >1.35 mmol/L were reviewed. We retrospectively analyzed the pharmacological treatment and recovery rate according to the severity of hypercalcemia. Results: A total of 177 cases were identified, of which 49 were not treated and 30 were treated with hydration only. In moderate-to-severe cases, 86.5% received pharmacological treatment. Thirty-four cases (19.2%) were treated with bisphosphonate alone and 58 cases (32.8%) were treated with bisphosphonate and calcitonin. In mild hypercalcemia cases, the recovery rate was higher for those receiving hydration only or pharmacological treatment (79.7%) than for those receiving no treatment (61.4%, p = 0.041). Most moderate-to-severe cases were treated with medication and of those treated, 56.3% recovered. The recovery rate was lower in those treated with bisphosphonate alone (38.2%) than in those who underwent calcitonin combination treatment (73.7%, p = 0.001). Conclusions: Bisphosphonate combined with calcitonin was found to be more effective than bisphosphonate alone for the treatment of moderate-to-severe hypercalcemia. Considering the current shortage of calcitonin, further efforts are required to ensure its stable supply.

Evaluation of Clinical Outcomes by Therapeutic Dosing Interval of Denosumab (Prolia®) and Calcium-Vitamin D Prescriptions (Denosumab (Prolia®)의 투여 간격 및 칼슘·비타민 D 복합제제 처방 여부에 따른 임상적 결과 평가)

  • Kim, Youkyeong;Kim, Junghyun;Doh, Hyunjeong;Jeong, Young Mi;Lee, Jeonghwa;Lee, Ju-Yeun;Lee, Euni
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.185-190
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    • 2022
  • Background: Denosumab (Prolia®) is administered every 6 months for osteoporosis treatment. Co-administration of calcium and vitamin D is required to minimize hypocalcemia risk. We evaluated clinical outcomes based on the administration interval of denosumab and co-prescription with calcium-vitamin D combination products. Methods: A retrospective study was conducted using electronic medical records from 668 patients who started denosumab therapy between January 1 and December 31, 2018, at Seoul National University Bundang Hospital. Clinical outcomes, as measured by changes in T-score, were evaluated by the intervals and concurrent prescriptions with calcium-vitamin D combination products. Results: Of the 668 patients, 333 patients met the eligibility criteria. These patients were divided into two groups based on appropriateness of the administration interval: "Appropriate" (304 patients, 91.3%) and "Inappropriate" (29 patients, 8.3%). T-score changes were significantly higher in the "Appropriate" than in the "Inappropriate" group (0.30±0.44 vs. 0.13±0.37, p=0.048). At the beginning of the treatment, 221 patients (66.4%) were prescribed calcium-vitamin D combination products, but the changes in T-scores were not significantly different by the prescription status of the product (0.29±0.46 vs. 0.28±0.38, p=0.919). Conclusion: T-scores were significantly improved in patients with appropriate administration intervals. No significant changes in T-scores were observed by the prescription status with calcium-vitamin D combination products. For optimal treatment outcomes, prescribers should encourage adherence to the approved prescription information on dosage and administration, and pharmacists should provide medication counseling for patients.